SEARCH · PubMed Health

Results for “ADHD subtypes”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 199 records · Page 11Linked to original sources

PubMed2006

Placebo-controlled study examining effects of selegiline in children with attention-deficit/hyperactivity disorder.

There is evidence suggesting a role for dopamine in attention-deficit/hyperactivity disorder (ADHD). Pharmacological treatments that act on the dopamine system have been successful in reducing ADHD symptoms. However, unlike traditional stimulants (i.e., methylphenidate), selegiline is a monoamine oxidase inhibitor (MAOI) that has been shown to reduce ADHD symptoms without producing undesirable side effects. In this study using a randomized, double- blind, placebo-controlled, crossover design, cognitive tasks and behavioral rating scales were administered to measure the effectiveness of selegiline in treating different symptoms of ADHD in 11 children aged 6-13. Results indicate that selegiline may target specific symptoms of ADHD including: sustained attention, the learning of novel information, hyperactivity, and peer interactions. Because the drug was not associated with negative side effects and did not specifically reduce symptoms of impulsivity, selegiline may be a preferred treatment for individuals who present with the primarily inattentive subtype of ADHD.

Adolescent↗

PubMed2005

Phenotypic subtypes in attention deficit hyperactivity disorder in an isolated population.

We address the use of two informants in genetic studies and whether familial aggregation is similar for the three phenotypic subtypes of ADHD. Lifetime ADHD was diagnosed in a Dutch isolated population using parents and teachers as informants, creating two subgroups (one or two informants), then further divided into three phenotypic categories (inattentive, hyperactive/impulsive, combined). Genealogy was collected for all patients. Mean kinship coefficients for the subgroups were calculated. Fifteen of 26 children were linked to a common ancestor within 10 generations. The mean kinship coefficient of patients confirmed by two informants was significantly higher than in patients only scored positive by one informant (p = 0.03). All patients of the inattentive subtype were connected to a common ancestor, which was significantly higher (p = 0.03) than expected. Eighty-one percent of these patients derive of consanguineous marriages, also higher than expected. This means that recessive mutations may be involved in the inattentive subtype. These patients were more closely related than those with the other phenotypes (p<0.01). Our data suggests that using two informants in diagnosing ADHD helps identify a phenotype with a strong genetic component. The inattentive phenotype showed strong familial clustering and evidence of a recessive origin.

Adolescent↗

PubMed2000

No association between low- and high-activity catecholamine-methyl-transferase (COMT) and attention deficit hyperactivity disorder (ADHD) in a sample of Turkish children.

Biochemical and genetic studies of attention deficit hyperactivity disorder (ADHD) suggest that regulation of catecholamine neurotransmission is a key factor in the aetiology of the disorder. In particular, it is postulated that an underactive dopamine system is associated with the disorder. In this study we have tested this hypothesis by screening a clinical sample of Turkish children with the combined subtype of ADHD with a functional variant of catecholamine-methyl-transferase (COMT) that codes for high- and low-activity variants of the enzyme. Using within-family tests of association and linkage in a sample of 72 children, we found no evidence for a genetic association or linkage. We conclude that altered regulation of catecholamines due to this polymorphism does not have a significant main effect on the risk for ADHD in this population. However, it remains feasible that more minor effects or interacting effects with other genes or environment exist.

Alleles↗

PubMed1998

Diagnosing attention deficit disorders with the Behavioral Assessment System for Children and the Child Behavior Checklist: test and construct validity analyses using optimal discriminant classification trees.

The usefulness of the Behavioral Assessment System for Children (BASC) and Child Behavior Checklist (CBCL) Parent scales was examined with respect to (a) differentiating students with attention deficit-hyperactivity disorder (ADHD) from non-ADHD students and (b) discriminating between the predominantly inattentive-type and combined-type ADHD-afflicted students. For both the BASC and the CBCL, a different optimal discriminant classification tree analysis (CTA) model was developed for each of the 2 diagnostic predictions. For distinguishing ADHD students from non-ADHD students, the BASC model was more parsimonious and accurate than the CBCL model. Toward the goal of differentiating between primarily inattentive and combined types, the CBCL's model was superior for predicting primarily inattentive students. The results demonstrate the diagnostic utility of the BASC and CBCL and describe salient behavioral dimensions associated with subtypes of ADHD.

Attention Deficit Disorder with Hyperactivity↗

PubMed2005

DNA pooling analysis of 21 norepinephrine transporter gene SNPs with attention deficit hyperactivity disorder: no evidence for association.

The norepinephrine system is known to play a role in attentional and cognitive-energetic mechanisms and is thought to be important in attention deficit hyperactivity disorder (ADHD). Stimulant medications are known to alter the activity of norepinephrine as well as dopamine in the synapse and the highly selective norepinephrine reuptake inhibitor, atomoxetine, is an effective treatment for ADHD symptoms. This study set out to investigate whether common polymorphisms within the norepinephrine transporter gene (NET1) are associated with DSM-IV ADHD combined subtype, using a sample that has previously shown association with genes that affect the synaptic release and uptake of neurotransmitters; DAT1 and SNAP-25. We identified 21 single nucleotide polymorphisms (SNPs) from publicly available databases that had minor allele frequencies > or =5% and span the NET1 genomic region, including those analyzed in previous studies of ADHD. DNA pooling was used to screen for associations using two case pools (n = 180 cases) and four control pools (n = 334 controls). We identified three SNPs that showed suggestive evidence for association using either case-control or within family tests of association, however, none of these were significant after adjustment for the number of markers analyzed. We conclude that none of the markers show significant evidence of association with ADHD although we cannot rule out small genetic effects.

Algorithms↗

PubMed2005

Disentangling deficits in adults with attention-deficit/hyperactivity disorder.

CONTEXT: A lack of inhibitory control has been suggested to be the core deficit in attention-deficit/hyperactivity disorder (ADHD), especially in adults. This means that a primary deficit in inhibition mediates a cascade of secondary deficits in other executive functions, such as attention. Impaired stopping has been claimed to support the inhibition hypothesis. However, executive functions such as inhibition and attention are hard to disentangle. OBJECTIVE: To use event-related potentials in adult patients with ADHD to show that impaired stopping is associated with abnormalities of attention. DESIGN: The stop signal task was presented to 24 adults with ADHD combined subtype and 24 controls. Stop event-related potentials are distorted by overlap from event-related potentials to other stimuli in close temporal proximity, but we applied a method (Adjar level 2) to effectively remove this overlap. RESULTS: In line with an inhibitory control deficit, the stop signal reaction time was longer in adults with ADHD (F(1,46) = 7.12, P<.01) whereas there was no significant difference for go stimulus reaction time. Overlap-free stop event-related potentials revealed smaller stop P3s in adults with ADHD (F(1,44) = 4.20, P<.05). In children with ADHD, this has been interpreted to reflect deficient inhibitory control. However, controls were also found to have larger early responses in the auditory cortex (N1) when stop signals resulted in successful stops, relative to failed stops, signifying increased attention (F(1,23) = 11.88, P<.01). This difference was completely absent in adults with ADHD. CONCLUSIONS: Disturbed attentional processing of the stop signal contributed to impaired stopping in adults with ADHD. This finding may have implications for treatment.

Adolescent↗

PubMed2005

Substance use disorder characteristics and externalizing problems among inpatient adolescent smokers.

Attention deficit hyperactivity disorder (ADHD) and/or conduct disorder (CD) have been found to be associated with substance use disorders and cigarette smoking among adolescents. However, studies have often failed to explore these relationships among females from a dimensional perspective, taking into account comorbidity between ADHD and CD symptomatology, and examining ADHD symptom subtypes (i.e., inattention and hyperactivity/impulsivity) separately as they relate to substance involvement and smoking characteristics. This study takes each of the above into consideration when examining the relationship between externalizing symptomatology and substance involvement characteristics in a sample of 191 (62.3% female, mean age = 15.4 years) inpatient adolescent smokers. The results of this study suggest that ADHD and CD symptoms may be related to different types of substance use characteristics. CD symptoms were associated with early onset of substance involvement and ADHD symptoms were related to alcohol and marijuana frequency. ADHD inattention symptoms, but not hyperactivity/impulsivity symptoms, were associated with marijuana and nicotine dependence. Lastly, significant interactions suggested that ADHD symptoms among boys and CD symptoms among girls were related to frequency of any type of substance use prior to inpatient hospitalization. The results of this study point to potentially important clinical implications such as tailoring prevention and intervention efforts according to type of externalizing symptomatology and gender.

Adolescent↗

PubMed1990

Inattentive and noninattentive ADHD children: do they constitute a unitary group?

Teacher-rated ADHD and normal control children were administered a continuous performance test (CPT), and were then further subdivided based upon the presence or absence of objectively assessed attentional deficits. In addition, children were assessed using several measures of cognitive and behavioral functioning. Attentional deficits were significantly more prevalent among the ADHD group, but about half of the ADHD children showed no evidence of objectively assessed attentional dysfunction. Further group analyses indicated that ADHD children with objectively assessed attentional dysfunction appeared cognitively impaired, while ADHD children without objective evidence of attentional dysfunction had more conduct problems. CPT inattention was not related to the presence of cognitive impairments or conduct problems in the control group. These data must be considered preliminary because teacher ratings were the only source of diagnosis and a single measure of inattention was used. However, they suggest that two subtypes of ADHD children can be identified, one characterized by inattention and learning problems, and the other by conduct problems.

Achievement↗

PubMed2000

Adrenomedullary function during cognitive testing in attention-deficit/hyperactivity disorder.

OBJECTIVE: Reported correlations between epinephrine (EPI) excretion and classroom performance, the cognition-enhancing effects of EPI infusion, increased EPI excretion with stimulants, and reports of decreased EPI excretion in attention-deficit/hyperactivity disorder (ADHD) suggest that sympathoadrenomedullary function might be altered in ADHD. This hypothesis was tested by examining sympathetic and adrenomedullary functioning during cognitive testing in boys with diagnosed ADHD. METHOD: Urinary excretion of EPI and norepinephrine during a 3-hour cognitive test battery was assessed in 7- to 13-year-old boys. Excretion rates (nanograms per hour per square meter of body surface area) were determined in 200 individuals with ADHD (diagnosed according to DSM-IV criteria), with or without co-occurring oppositional defiant/conduct disorder or learning disorder. A non-ADHD contrast group (n = 51) with similar comorbidity was also studied. RESULTS: Substantially lower (mean +/- SE) urinary EPI excretion was observed in the ADHD-inattentive subtype (n = 71) compared with the control group (200 +/- 22 versus 278 +/- 24 ng/hr/m2; F = 5.99, p = .015, critical alpha = .017). No diagnostic group differences were seen for norepinephrine excretion. Correlational analysis of both parent- and teacher-rated behaviors revealed that inattention factors consistently negatively predicted urinary EPI excretion. CONCLUSIONS: The data extend findings of lower adrenomedullary activity during cognitive challenge in individuals with ADHD and suggest that the alteration is associated with inattentive behavior.

Adolescent↗

PubMed2003

A chart review study of the inattentive and combined types of ADHD.

Studies of the clinical correlates of the subtypes of Attention-Deficit/Hyperactivity Disorder (ADHD) have identified differences in the representation of age, gender, prevalence, comorbidity, and treatment. We report retrospective chart review data detailing the clinical characteristics of the Inattentive (IA) and Combined (C) subtypes of ADHD in 143 cases of ADHD-IA and 133 cases of ADHD-C. The children with ADHD-IA were older, more likely to be female, and had more comorbid internalizing disorders and learning disabilities. Individuals in the ADHD-IA group were two to five times as likely to have a referral for speech and language problems. The children with ADHD-IA were rated as having less overall functional impairment, but did have difficulty with academic achievement. Children with ADHD-IA were less likely to be treated with stimulants. One eighth of the children with ADHD-IA still had significant symptoms of hyperactivity/impulsivity, but did not meet the DSM-IV threshold for diagnosis of ADHD-Combined Type. The ADHD-IA subtype includes children with no hyperactivity and children who still manifest clinically significant hyperactive symptomatology but do not meet DSM-IV criteria for Combined Type. ADHD-IA children are often seen as having speech and language problems, and are less likely to receive medication treatment, but respond to medical treatment with improvement both in attention and residual hyperactive/impulsive symptoms.

Attention Deficit Disorder with Hyperactivity↗

PubMed2006

[Aspects concerning behavioural development and socialisation and how they are linked to attention deficit hyperactivity disorder].

INTRODUCTION: Despite their importance, little attention has been given to the recognition of early markers of hyperactivity in the scientific literature and in everyday practice it can be difficult to separate some of the physiological behaviours displayed by older babies or preschool infants from pathological processes such as attention deficit hyperactivity disorder (ADHD), specific language impairment, autistic spectrum disorders, conduct disorders or bad habits with regard to discipline within the family context. DEVELOPMENT: Knowledge of some of the key points in behavioural development and sociability in children can help reach a correct interpretation of the manifestations observed in this age group. The development of linguistic competencies, a feeling of what is right and what is wrong, the development of an awareness of oneself and the capacity to infer that is established as progress is made in language are some of the keys to proper behavioural development and socialisation. The gene DRD4 is expressed in the prefrontal cortex and has been implicated in some subtypes of ADHD, as well as being linked to a novelty-seeking personality. Recent genetic evidence supports the notion of an association between certain polymorphisms in the DRD4 gene with resistant or disorganised bonds at early ages. CONCLUSIONS: The detection of several dysfunctional signs related to inadequate self-control that appear during behavioural development and socialisation may provide early keys to the future development of ADHD.

Attention Deficit Disorder with Hyperactivity↗

PubMed2006

[Sluggish cognitive tempo: symptoms of predominantly inattentive attention deficit hyperactivity disorder or a new clinical entity?].

INTRODUCTION: The attention deficit/hyperactivity disorder (ADHD) is an heterogeneous entity with three accepted subtypes. This article reviews changes in the diagnostic criteria and controversies around the ADHD subtypes. DEVELOPMENT: We review the sluggish cognitive tempo, construct which has been associated with the ADHD predominantly inattentive subtype. We illustrate this construct through examining clinical cases that manifest 'sluggish cognitive tempo' symptoms. CONCLUSION: This article raises questions such as the utility of the sluggish cognitive tempo in the diagnosis of ADHD predominantly inattentive, and the possibility that it is a clinical entity not described up to the present date.

Adolescent↗

PubMed2003

Clinical course of attention-deficit/hyperactivity disorder from childhood toward early adolescence.

OBJECTIVE: To study the course of attention-deficit/hyperactivity disorder (ADHD) in late childhood to adolescence using a multi-informant and multi-assessment procedure. METHOD: Subjects were 35 children with ADHD and 35 matched controls with a mean age of 10 years at first assessment. DSM-III-R-based structured diagnostic interviews and behavioral questionnaires based on parents, teachers, and youth informants were used. Cross-informant behavioral syndromes were obtained by use of the Child Behavior Checklist, the Teacher's Report Form, and the Youth Self-Report. Subjects were reassessed after 1.5 and 2.6 years. RESULTS: Behavioral differences between the two groups were significant for the majority of scales for all three informants at all three times. Diagnostic interviews revealed a persistence rate of 46% over 2.6 years. However, there were only few significant behavioral differences across informants between the nonpersistent and the persistent groups. The fit between interview-derived syndrome scores reflecting subtypes of ADHD and both parents and youth questionnaire data was good, whereas for the teacher ratings it was poor. A high rate of 89% correct classification of the outcome diagnoses was possible based on behavioral data at time 1. CONCLUSIONS: The study of the course of ADHD should be based both on interview and questionnaire data and should include several informants. Operationally defined diagnoses alone may lead to an underestimation of persistent behavioral problems.

Adolescent↗

PubMed2006

Attention-deficit hyperactivity disorder and blood mercury level: a case-control study in Chinese children.

OBJECTIVE: To investigate the association between blood mercury level and attention-deficit hyperactivity disorder (ADHD) in Chinese children in Hong Kong. METHODS: Fifty-two children with ADHD aged below 18 years diagnosed by DSM IV criteria without perinatal brain insults, mental retardation or neurological deficits were recruited from a developmental assessment center. Fifty-nine normal controls were recruited from a nearby hospital. Blood mercury levels were measured by cold vapor atomic absorption spectrophotometry. RESULTS: The mean ages of cases and controls were 7.06 and 7.81 years respectively. Boys predominated (case = 44 [84.6 %], control = 44 [74.6 %]). There was significant difference in blood mercury levels between cases and controls (geometric mean 18.2 nmol/L [95 % CI 15.4 - 21.5 nmol/L] vs. 11.6 nmol/L [95 % CI 9.9 - 13.7 nmol/L], p < 0.001), which persists after adjustment for age, gender and parental occupational status (p < 0.001). The geometric mean blood mercury level was also significantly higher in children with inattentive (19.4 nmol/L, 95 % CI 13.3 - 28.5 nmol/L) and combined (18.0 nmol/L, 95 % CI 14.9 - 21.8 nmol/L) subtypes of ADHD. Blood mercury levels were above 29 nmol/L in 17 (26.9 %) cases and 6 (10.2 %) controls. Children with blood mercury level above 29 nmol/L had 9.69 times (95 % CI 2.57 - 36.5) higher risk of having ADHD after adjustment for confounding variables. CONCLUSION: High blood mercury level was associated with ADHD. Whether the relationship is causal requires further studies.

Adolescent↗

PubMed2005

[Long-acting methylphenidate. An alternative medical therapy for adult patients with attention deficit hyperactivity disorder].

We report a 44-year-old female patient with attention deficit hyperactivity disorder (ADHD), combined subtype (DSM-IV: 314.01), who was treated with 0.5 mg of short-acting immediate-release methylphenidate/kg body weight given t.i.d. (total daily MPH IR dosage 45 mg). Under this medication, the patient reported significant reduction of symptoms. However, several times a day she experienced severe rebound phenomena with pronounced concentration disturbances, unrest, and dysphoric mood. After changing the medication to long-acting methylphenidate once daily (total daily OROS MPH dosage 54 mg), the rebound phenomena stopped, with equivalent beneficial clinical effects.

Adult↗

PubMed2006

Accuracy of drawing in a dual-task and resistance-to-distraction study: motor or attention deficit?

To determine whether manual incoordination is caused by attention deficit or not, we used an accuracy drawing task as a primary task in dual-task and resistance-to-distraction studies, and examined if thus measured attention could differentiate inattention (IA) and combined (CO) subtypes of ADHD. The secondary tasks and distractions failed to lower the primary task performance in IA, CO and control groups. We also compared the impairment scores of the accuracy drawing tasks from the Movement Assessment Battery for Children [Henderson, S. E., & Sugden, D. A. (1992). Movement assessment battery for children. London: Psychological Corporation.] between the groups with attention deficit hyperactivity disorder (ADHD) and/or developmental coordination disorder-inaccurate drawing type (DCD-ID). There were no group differences in the impairment score between the control and the ADHD groups, and between ADHD and ADHD plus DCD-ID groups. We concluded that inaccurate drawing is not caused by attention deficit, but that it is a manifestation of a motor deficit as a separate entity from attention deficit.

Adolescent↗

PubMed2006

Smoking during pregnancy and attention-deficit/hyperactivity disorder, predominantly inattentive type: a case-control study.

OBJECTIVE: Few previous studies assessed specifically attention-deficit/hyperactivity disorder, predominantly inattentive subtype (ADHD-I) in nonreferred samples. This study investigated the association between ADHD-I and prenatal exposure to nicotine. METHOD: In a case-control study performed between September 2002 and April 2005, we assessed a nonreferred Brazilian sample of 100 children and adolescents with ADHD-I and 100 non-ADHD controls (6-18 years old). Cases and controls, matched by gender and age, were screened using teacher reports in the Swanson, Nolan, and Pelham-IV (SNAP-IV) scale. They were systematically evaluated through structured diagnostic interviews. Prenatal exposure to nicotine and potential confounding factors were evaluated by direct interview with mothers. RESULTS: Adjusting for confounding factors (maternal ADHD, oppositional defiant disorder, birth weight, and alcohol use during pregnancy), children whose mothers smoked>or=10 cigarettes per day during pregnancy presented a significantly higher odds ratio for ADHD-I than children who were not exposed to nicotine during pregnancy (odds ratio 3.44; 95% confidence interval 1.17-10.06). Dimensional analyses showed significantly higher inattentive scores in subjects whose mothers smoked>or=10 cigarettes per day than in others after adjusting for confounding factors (p=.002). CONCLUSIONS: In a nonreferred sample, the authors expanded to ADHD-I previous findings documenting the association between prenatal exposure to nicotine and broadly defined ADHD in clinical samples.

Adolescent↗

PubMed2004

[Grammatical complexity and cohesion mechanisms in the communicative pragmatics of children with attention deficit hyperactivity disorder].

AIMS: The purpose of this study was to compare the grammatical structures and cohesion used in the narrative sequencing of real events by children with and without attention deficit hyperactivity disorder. SUBJECTS AND METHODS: A total of 27 children, between the ages of seven and eight, took part in the study; 15 of them had the combined subtype of ADHD and 12 participated as a control group. To obtain the narration the children were asked to talk about two real events they had experienced: 'What happened the last time you went to the doctor's?' and 'Have you ever been bitten by an insect?' An analysis of their narrations allowed us to obtain the following variables: the total number of communication units, their average length, the syntactic complexity index, the rate of lexical diversity, the lexical type referential cohesion procedures, the deictic and anaphoric grammatical procedures, the conjunctive procedures, discourse markers, changes of subject matter and dysfluency. RESULTS: Results show that there are significant differences between the two groups in the narrative cohesion indicators used, the group of normal children being those that were favoured by these differences. The most striking pragmatic peculiarities were difficulties in the use of conversational markers and the changes in the subject being discussed. CONCLUSIONS: The narratives of children with attention deficit hyperactivity disorder are more difficult to understand, which means that the listener has to adopt a more active role in order to make up for the missing information and has to infer a great deal more. This is an aspect that can have social implications and may make communication more difficult, especially with their peers, since these usually make less effort to understand the conversations than adults do.

Adult↗